Wellbeing FAQs for Doctors during Covid-19

The COVID-19 global outbreak has heralded the most challenging times for all with healthcare workers on the frontline of the crisis. We are currently spending a great amount of time supporting doctors on their individual situations.

Here is a list of common FAQs we deal with which will be updated regularly:

1. I have a health condition which puts me in the vulnerable or shielding group. Should I be doing face to face healthcare work?

2. I am vulnerable, however have confirmed COVID + test and I’m feeling better. Can I go back to work on the frontline?

3. I want to return to help the medical front line – how do I go about doing this?

4. I don’t wish to return to the medical front line but want to help in another way. How do I go about doing this?

5. Will my indemnity insurance cover any activities beyond my usual clinical work?

6. If I’m a returner, do I need to get extra indemnity?

7. What happens if I start seeing my patients remotely?

8. Am I allowed stay at home and look after my child now that schools have shut?

9. I am feeling distressed about the current situation – what wellbeing support is available to me?

10. I’m having difficulty communicating my health needs to my supervisor / line manager – how do I best deal with this?

11. I don’t feel safe at work given the increased health risks – what can I do?

I have a health condition which puts me in the vulnerable or shielding group. Should I be doing face to face healthcare work?

When the UK government declared a list of health conditions where individuals should employ particularly stringent social distancing measures including shielding for those at the highest risk, there was a lot of confusion amongst healthcare workers about whether or not this applied to them.

Generally speaking, if you are over 70, or are deemed particularly vulnerable and/or in the shielding category, you should be reducing your exposure to COVID-19 as much as possible, which ideally means working from or staying at home. 

For those unsure about particular health conditions, the Faculty of Occupational Medicine have released an  advisory sheet for healthcare workers and further guidance specific to various health conditions in detail (PDF).

You can also find further risk stratification detail on the Workfit website.

You can still do clinical work from home (e.g. telephone, videoconferencing, ‘paper-based’, however your face to face clinical work should cease because the risk to your health is significant if you were to catch the virus and become unwell.

Your employer should support you if you need to stay at home for health reasons. Check out the ACAS website for more information on your rights and unlawful discrimination as a consequence of going against the guidelines.

 

I am vulnerable, however have confirmed COVID + test and I’m feeling better. Can I go back to work on the frontline?

At this time it’s unclear. One would presumed that if you’ve survived a COVID infection and you’re well, you should be safer to go back to work, however it is unknown as to whether you are indeed immune to COVID (particularly if immunosuppressed), and little is known about what could happen if you were re-infected.

I want to return to help the medical front line – how do I go about doing this?

In the UK, the NHS has already invited thousands of retired doctors to return with provision of a special temporary licence with the General Medical Council.

In such emergencies, the GMC can grant temporary registration to certain groups, the first being fully qualified and experienced doctors of good standing who have recently relinquished their registration or licence to practise. Those wishing to return to primary care will also need to be included on the Performers List.

If you have not been invited directly, you can also complete this survey link  they have released or if you have any further queries, do please email nhsi.medical.nonGP.returners@nhs.net or nhsi.medicalGP.returners@nhs.net as appropriate.

Alternatively – contact your local hospital or healthcare facility to explore if and/or how you can get involved.

Are you seeking support for returning to the NHS? Check out a useful webinar run on this topic

 

I don’t wish to return to the medical front line but want to help in another way. How do I go about doing this?

We appreciate that for various reasons, not all doctors; current or retired, wish to work on the medical frontline.

However, your colleagues and local community are in urgent need of your support to join the fight against COVID-19 in a number of different ways that don’t have to involve frontline care.

This isn’t only about clinically treating patients –  your expertise can help in so many ways, so even if you fall into a group which is considered to be at increased risk, you can still offer valuable support through a variety of roles in secondary, community and primary care.

 

Will my indemnity insurance cover any activities beyond my usual clinical work?

If you are working for an NHS trust directly, you should be covered by the Clinical Negligence Scheme for Trusts (CNST).

If working for a GP practice, you should be covered by the Clinical Negligence Scheme for General Practice. Check with your employer.

If you are a returner to the NHS you should also be covered by this.

 

If I’m a returner, do I need to get extra indemnity?

The Medical Protection Society (MPS) will provide professional indemnity protection at no cost. More information for returning members wanting to take advantage of the Coronavirus Support protection should visit their website.

 

The Medical and Dental Defence Union of Scotland (MDDUS) will automatically provide professional indemnity protection at no cost to their retired members returning to work on the COVID-19 response and will write shortly to all who have retired in the last 3 years setting out details. There is no need for retired MDDUS members to contact the company to take advantage of this Coronavirus Support product, but information will be available at MDDUS.com or if needed on 0333 043 0000.

The Medical Defence Union (MDU) has confirmed that retired members returning to work specifically to help out as part of the COVID-19 response should visit themdu.com/coronavirus, when they are ready to start in their new role. Membership benefits for non-claims matters, such as help with complaints, GMC investigations or inquests, can then be made available if needed. Their membership team can be contacted on 0800 716 376 for any questions not covered on the site.

 

What happens if I start seeing my patients remotely?

Many doctors might have to consult with patients remotely more frequently than normal. In making the decision to consult and advise patients remotely, doctors must balance the risks and benefits and be satisfied that they can adequately clinically assess the patient remotely. Medical Defence Organisations (MDOs) advise doctors to make a record of the reasoning behind any decisions made and the information they give to patients in case they need to explain the approach they’ve taken later on.

 

Am I allowed stay at home and look after my child now that schools have shut?

If you are a medic in a key worker role, your children should still be entitled to go to school.

We however appreciate that not all doctors are in roles which would classify them as key workers. In which case you may have to discuss your situation directly with your employer and consider options for furlough under the Coronavirus Retention Scheme if there is no alternative for childcare and as a result you are unable to reasonably work.

I am feeling distressed about the current situation – what wellbeing support is available to me?

We understand that this is an incredibly challenging time for all health professionals, and looking after your wellbeing is essential not only for you but also your patients. There are several resources/approaches you may wish to consider:

• Join the Medic Footprints Coronavirus Wellbeing Support for Doctors UK group, led by doctors who specialise in supporting other doctors
• Check out our Coronavirus Wellbeing Support for Doctors page
• The BMA’s helpline can connect you to counselling and peer support services which is supposed to be free to doctors (member or not) – call 0330 123 1245
• Schedule regular phone calls and/or video calls with family and friends – ‘fill your tank’ with love, community and encouragement

I’m having difficulty communicating my health needs to my supervisor / line manager – how do I best deal with this?

Firstly, try to stay mindful and empathetic of the fact that this is a very difficult time for everyone – including your supervisor/line manager – and they themselves may be struggling to stay grounded and/or stay on top of their duties. Furthermore, accept that they are invariably dealing with professional and personal challenges that you are not privy to – so try to ‘keep the door open’ to this in your mind, as challenging as that can be.

That said, you have a right to be heard and your manager has a duty to listen to you, and to support you as much as possible to ensure your needs are met.

Here are some simple tips to maximise the likelihood of effective communication and effective listening on both sides:

In first instance, state clearly that you need to speak with your manager and that the issue is important to address. No doubt they will be busy when you approach them, so rather than trying to get into the detail then and there, we suggest you agree a time to speak. This increases the odds that they will be able to focus on you and your needs.

 

Should your manager say that they have no time or there are more important issues to deal with, work to stay calm and ‘online’. Your response should clearly state

a) the consequence of them not listening as well as

b) the benefit of them doing so.

 

For example:

“I appreciate that you are very busy at the moment. However, it is essential that we speak soon to discuss X. If we do not, then this will ultimately interfere with my ability to care for patients and your ability to run an effective service. “

On the other hand, by speaking briefly to address this issue, I will a) be able to focus on our core work and b) be grateful for your help, and c) you will be reassured that the service is being run as effectively as possible

 

There is still a small chance that even saying clearly this will not get through to them, as they may simply be struggling to focus on you given everything else that is racing through their mind. If this is the case, and you have set out your case and needs as clearly as possible, then consider who else you can speak with to help get your needs met – both in terms of pastoral care and practical solutions.

However, even when approaching another person, still let the goal be to get your manager to help meet your needs; as opposed to creating a ‘reach around’ strategy that could undermine your long term relationship with your manager.

When you speak with them, we’d encourage you to use this classic four step approach, which is designed to maximise the likelihood that you will convey your needs effectively and your manager will be able to hear you.

1) State what you observe or don’t observe (so that they understand what you are addressing specifically)

2) state what your feelings are towards that (so that they understand the human element underlying your observation)

3) state your needs (so that they understand they underlying issue e.g. respect, safety, clarity)

4) state your request (so that they understand what you are asking them to do with the information you have shared)

 

I don’t feel safe at work given the increased health risks – what can I do?

This is a surprisingly common issue for doctors which can be a very challenging emotional and political minefield to cross.

The first step is to clearly communicate your concerns about the health risks with suggestions on how it could either be improved or made safe so you can do your job. You can also offer to work in a different way that you feel is acceptable as an alternative and most importantly, is safe.

If this isn’t addressed and you feel at risk doing the job, you are within your rights to refuse to do so under health and safety grounds. It is important that you document any conversations you’ve had including the people you’ve spoken to.

The BMA says:

Where you reasonably believe that your protective equipment is inadequate, you need to raise this urgently with your managers. Your manager should carry out a risk assessment and find alternative ways of providing the care and treatment.

There are limits to the risks you can be expected to expose yourself to. You are not under a binding obligation to provide high-risk services where your employer does not provide appropriate safety and protection.

Any other questions that need addressing? 

Email us at mfteam@medicfootprints.org